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Shared Accountability in Healthcare
Editors’ Note
Prior to assuming her current post in March of 2012, Laura Kaiser served as President and Chief Executive Officer of Sacred Heart Health System based in Pensacola, Florida, and Regional Executive for the Gulf Coast/Florida region of Ascension Health. A native of St. Louis, Missouri, Kaiser earned a Master of Business Administration and a Master of Healthcare Administration from Saint Louis University and a Bachelor of Science degree in Health Services Management from the University of Missouri. She is a Fellow of the American College of Healthcare Executives and has served on several boards including the Daughters of Charity Foundation, Utah Hospital Association, Utah Symphony, Utah Opera, and Westminster College.
Institution Brief
Based in Salt Lake City, Utah, Intermountain Healthcare (intermountainhealthcare.org) is a not-for-profit health system with more than 34,000 employees serving the healthcare needs of Utah and Idaho residents. Intermountain’s system of 22 hospitals, medical groups, clinics, and health plans provides clinically excellent medical care at affordable rates.
What makes this organization so special?
Intermountain truly is a special organization. With the tremendous continuity of leadership over the years, our focus on becoming a model healthcare organization and providing high-quality, evidence-based medicine that is affordable is unrelenting. The culture at Intermountain is very healthy, with people rowing the boat well together. With this kind of team approach, mountains can be moved.
Even with the size and scale of Intermountain, how important is it to remain an innovative organization?
Innovation is the critical lifeblood to any organization. We actively embrace innovation and are always thinking about continuously improving our organization to better serve those who entrust their care to us. For example, beginning in the mid-1950s, Dr. Homer Warner began his work using computers for decision support in cardiology at one of Intermountain’s hospitals in Salt Lake City. His groundbreaking work set the stage for the growth of the new field of academic study called medical informatics. In the 1970s, Dr. Warner and his Intermountain colleagues created one of the nation’s first versions of an electronic medical record. Designed to assist clinicians in decision-making, the Intermountain team continues to build on that innovative work today.
What are the key industry challenges and are you optimistic the industry can meet those needs effectively?
I am optimistic about the healthcare industry. Our industry has several opportunities to improve access to healthcare, to build on the high quality that is available in our country, and to do so at a more affordable and sustainable rate. We have the best health system in the world for rescue care and we have the opportunity to expand that by making significant strides in preventive care as well. At Intermountain, we are focused on transitioning from the current fee-for-service payment model to one that is organized by managing the health of a population. In our industry, it is incumbent upon all of us as leaders to think through how to make that transition as smooth, effortless, and effective as possible.
How much of a role can organizations like Intermountain play on the prevention side?
We are working closely with our patients, members, physicians, payers, and the communities in which we are located to help every person live his or her healthiest life possible. Our efforts have expanded to more deeply partner with patients and members to tailor individual care, whether it is proactive preventive care, an acute diagnosis that requires inpatient care, or a chronic condition that is better addressed in an outpatient setting such as a doctor’s office, at home, or some other setting.
A few years ago, we introduced a concept called LiVeWell. It’s a lifestyle, not a crash course, and it’s based on research and a better understanding of the complex challenges we each face in managing our health for a better quality of life. LiVeWell helps individuals make healthful choices and become more physically active in the journey to well-being through a healthier lifestyle. The LiVeWell concept has also expanded to community issues. For example, we have partnered with local school districts to positively and collectively reduce the alarming increase of childhood obesity by implementing a free program called STEP Express to help 4th-grade students work toward a healthier lifestyle through classroom lesson plans, physical activity, and a fitness challenge. We’ve also built community gardens at various sites across our system. There is more to do and we are excited about our growing role in preventive health.
Do you worry that the focus on technology will detract from the personal relationship between the healthcare provider and patients?
Technology cannot nor should it fully replace the value of a face-to-face, patient-provider interaction. Rather, I view technology as an enabler to the relationship. For example, we offer telehealth capabilities to improve access to critically needed services, such as behavior health, to patients who live in very rural areas. If there is a need for face-to-face care, we’ll use technology to make arrangements to transfer a patient and then use technology once again to help the provider best meet the needs of a patient. Used appropriately, technology has the ability to enhance the patient-provider relationship, not detract from it.•